Provider Demographics
NPI:1912410499
Name:SCHEIBEL, JOHANNA (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:SCHEIBEL
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2128
Mailing Address - Country:US
Mailing Address - Phone:855-222-7980
Mailing Address - Fax:
Practice Address - Street 1:386 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2128
Practice Address - Country:US
Practice Address - Phone:855-222-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-16-22529103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst